NORTH WALES CRITICAL CARE & TRAUMA NETWORK REGIONAL TRANSFER GROUP Thursday 4 th December 2017 1400-16:00hrs Room 3, Residents Building, Abergele Hospital. Present: Edward Farley-Hills, Intensivist, YG, Critical Care and Clinical Lead WCC&TN Sue O Keeffe, Network Manager, Wales Critical Care & Trauma Network Abigail Taberner, Data Administrator, Wales Critical Care & Trauma Network Nicola Vaughan-Jones, PDN, YG Dermot O Leary, Paramedic, WAST Chris Littler, Intensivist, WM Vincent O Keeffe, Consultant Anaesthetist, YGC John Glen, Intensivist, YGC and EMRTS Lead, Caernarfon base Owen McIntyre, Intensivist Morriston, EMRTS Transfer Lead In Attendance: Rachael Thistleton, Wales Critical Care & Trauma Network Administrator Minute taker 1. Welcome and Apologies EFH welcomed all to the meeting and accepted apologies from the following: Kit Chalmers, Charlotte Revell, Shobha Ramakrishnan, Chris Bradshaw, Trevor Haughton, Vincent O Keeffe, Amie Cavanagh, Jo White 2. Minutes of Last Meeting Minutes of last meeting were accepted as a true and accurate record. 3. Matters Arising No Action from the 12 th June 2017 By Whom 3.1 EFH agreed to compile an email to EFH send to staff regarding the importance of either leaving the form for GK or sending to the Network. 3.2 GK to circulate the importance of EFH/GK filling in each box on transfer forms. (EFH to remind GK of action) 3.3 GK to circulate the importance of ETA EFH/GK call. (EFH to remind GK of action) 4.1 AT to review transfer form completion AT compliance for 2015-2017 6.1 SOK and RT to review the programme SOK/RT to see if it is logistically possible to bring the workshops forward in the programme to be circulated to the group for consultation. 6.2 RT and AT to provide delegates with RT/AT map and specific location for each course. 7.1 AT to run a report on all North Wales AT staff with regards to Part A and Part B to be presented at next meeting. 9.1 SOK to liaise with WAST to request SOK that paramedic teams inform ED staff that transferring a patient with a chest drain is outside of their scope of practice unless accompanied by a hospital member of staff. Update?complete however SOK commented that there have been no more instances. 1
9.2 SOK and AC to draft a checklist for level 1 patients. 10.1 SOK to liaise with WAST regarding requesting pre-alerts for trauma patients and to report back to the BCUHB Trauma Board. 11.1 EFH to draft a document and share with the group for consultation. 11.2 SOK to circulate information regarding helicopter transfers to all ED and ICU staff 12.1 RT to liaise with EFH for a date early December 2017 SOK/AC SOK EFH SOK RT EFH commented on the retrieval team document that was to be completed with Karen Mottart. EFH has spoken to St Asaph WAST team leader re: interhospital transfer following major incident. There are logistical difficulties with providing teams and ambulances and therefore the document has been placed on hold. 4. North Wales Regional Assessment Auditing Feedback (presentation) SOK gave a graphical presentation of North Wales Regional Assessment Auditing and the following was discussed: Percent forms returned not 100% for North Wales however only 10-12 forms per month so this is possible. The trend is overall upwards. Data Completion/Compliance Requested at last meeting. SOK has fed back personally, including sending top tips and reiterating at the transfer course. Data Assessment continues in upward trend of goods and excellents. 5. North Wales Transfers- Governance SOK gave a governance presentation on the North Wales transfers. Following Chris Turners recent presentation on Compassionate Governance it has been decided to add in the excellent and good transfers as well as previous poor/borderline transfers. YG Mostly excellents, some good. It was noted that there should be learning from the good transfers, i.e. fully optimise patient YGC Mostly excellent, one borderline due to data completion (63%). It was noted that it is difficult to give feedback to agency staff who have now left. WM Mostly excellent / good. Poor transfers discussed mostly due to issues with CT2 undertaking transfers, but according to Guidelines should be ST3 or above. 6. Inter-hospital Transfer Checklists The group discussed the current different inter-hospital checklists. SOK commented that the recently re-written Designed for Life: Transfer of the Critically Ill Adult guidelines include the same checklist as is on the transfer bags. NV-J advised that YG are in the process of ordering new bags. Action 6.1: RT to send NV-J the transfer checklist Mark Knights has drafted another pre-transfer checklist specifically for trauma transfers. SOK noted this doesn t state trauma on it anywhere. It was agreed that this should be added. Action 6.2: RT to add Trauma to pre-transfer checklist title SOK advised that she had drafted the level 1 checklist with input from AC. It was agreed that the checklist be re-named Aide Memoir. Action 6.3: RT to rename the level 1 checklist Aide Memoir 7. Intra-hospital Transfer Checklists SOK reported that Venkat Sundaram contacted her by email to state his dislike of the current Network Intra-hospital Transfer checklist. SOK asked him to re-write however she has not heard whether this is complete as yet. Action 7.1: VS to re-write the Intra-hospital checklist for NW Action 7.2: RT to add re-vised intra-hospital checklist to next agenda 2
8. Transfer Course Evaluation & Feedback The Transfer Course held in Caernarfon Airport on the 29 th November was discussed. The evaluation from the candidates was overwhelmingly positive. DO L commented that the only negative was no transfer trolley availability, however in future it may be possible to collect en route. There was a specific question added to the evaluation with regards to travel, all delegates advised advantageous being on location at the airport. CL commented that it is a long distance for WM delegates (1.5 hours), however the feedback from the WM staff at the recent course was positive. SOK advised all courses for 2018 at Caernarfon, then if difficulties with WM candidates then there can be changes later in the year. The group agreed. Action 8.1: RT to amend evaluation form to advise feedback re: Caernarfon Printing handouts was also discussed, in 2016 the delegates overwhelming voted in favour to have them, however in 2017 there has been a shift. Therefore it was agreed to not have paper handouts, but to put the pre-course reading online and giving delegates the onus to print. 9. E-learning RT fed back to the group the update with regards to the E-learning package. The platform has changed several times with regards to the site which has caused delay. The link was sent to all with the agenda which is now not functional as it is being transposed onto ESR to go live. The group were requested to trial the online E-learning when RT advises it has gone live. Action 9.1: RT to check online ESR and update the group when live Action 9.2: All to complete E-learning and send feedback to the Network Office when live 10. Dates for 2018 It was agreed that all three Transfer Courses will be held at Caernarfon Airport in 2018 at the Air Ambulance base as the conference room is much larger. The dates need to be organised however are usually April, early July and October/November. Action 10.1: AT to look at dates for 2018 courses with JG 11. North Wales Staff Part A & B SOK commented that this item was a previous action, EFH had requested the list of staff that had completed parts A&B. SOK advised doing a further report for 2015 current for staff that have not done Part B and every time there is a course notify NV-J/JW/Lisa of staff who now require Part B. Difficulties were discussed trying to get people from ED notified of Part B. Action 11.1: AT to do report regarding staff who have not completed Part B; split into hospital and send out to JW/NV-J and Lisa Action 11.2: AT to notify NV-J/JW/Lisa of staff who now require Part B for each course following Part A 12. Progress on Part B CL advised the group that the last Part B course was cancelled in WM. CL commented that there is no facility to hold meetings and do training. SOK advised Jo White is now in post for YGC (previously Linda Brayshay had undertaken Part B) and therefore will check to ensure Part B is being completed. Action 12.1: SOK to discuss Part B with JW 13. Progress on Part C SOK reported that for the last Part C (Bristows) course there was only two people registered to complete the course, however on the day additional people arrived, who had not registered through the Network, as they had been advised to attend within YG. Action 13.1: EFH to request that staff book onto the Part C through the Network in order to notify the Bristows team who to expect. 3
There was a presentation from Owen McIntyre, EMRTS Transfer Lead on a proposed new EMRTS Part C course to familiarise hospital staff with EMRTS kit protocols and procedures. SOK commented that if ran as a ½ day course, it could be run on the same day as the Bristows course making a full day of Part C training. JG endorsed the idea. There is to be a pilot course in January in Abergavenny. Action 13.2: JG/OM to feedback at next NW regional transfer meeting 14. Walton Helipad SOP SOK mentioned an issue of a patient with a subarachnoid haemorrhage transferred to the Walton Centre, however the pilot was denied landing on the Aintree helipad as the patient was not a trauma patient. SOK informed the group that a draft SOP for Walton has been circulated by Steve Shaw, Neuro Anaesthetist from Walton. Therefore time critical head injured patients will now be able to land at Aintree. SOK hasn t sent the final document as phone numbers are required. SOK will send final document when finalised and received. Action 14.1: SOK to send out final document re: Walton Helipad SOP when finalised and received. Post Meeting Note : Action completed 15. AOB CL RSUH not taking isolated head injured patient. SOK advised has been dealt with by Trauma Board. SOK queried using a tablet platform for transfer form completion, however this would recommend every hospital transfer trolley has an ipad (or similar). DO L advised that there is Wi-Fi enablement in vehicles so he recommended linking in with WAST IT. SOK queried putting bid in for slippage money in 2018/19. DO L commented that WAST will be moving to tablets from e-pens. DO L advised that as the system is developed within WAST then there are possibilities to link in with them. Action 15.1: DO L will speak to the WAST IT link person and feedback to SOK Action 15.2: RT to add tablet platform for form completion to next agenda 16. Date of Next Meeting: There will be no transfer course until April 2018 and therefore the next meeting will be March to ensure governance issues are addressed in a timely manner. Action: RT to forward March 1 st to whole group 4
Action Card Transfer Group Meeting 4 th December 2017 No. Actions from the minutes of the 4 th December 2017 By Whom 6.1 RT to send NV-J the transfer checklist RT 6.2 RT to add Trauma to pre-transfer checklist title RT 6.3 RT to rename the level 1 checklist Aide Memoir RT 7.1 VS to re-write the Intra-hospital checklist for NW VS 7.2 RT to add re-vised intra-hospital checklist to next agenda RT 8.1 RT to amend evaluation form to advise feedback re: Caernarfon RT 9.1 RT to check online ESR and update the group when live RT 9.2 All to complete E-learning and send feedback to the Network Office when live ALL 10.1 AT to look at dates for 2018 courses with JG AT 11.1 AT to do report regarding staff who have not completed Part B; split into hospital and send out to JW/NV-J and Lisa AT 11.2 AT to notify NV-J/JW/Lisa of staff who now require Part B for each course following Part A AT 12.1 SOK to discuss Part B with JW SOK 13.1 EFH to request that staff book onto the Part C through the Network in order to notify the Bristows team who to expect. EFH 13.2 JG/OM to feedback at next NW regional transfer meeting JG/OM 14.1 SOK to send out final document re: Walton Helipad SOP when finalised and received. SOK 15.1 DO L will speak to the WAST IT link person and feedback to SOK DO L 15.2 RT to add tablet platform for form completion to next agenda RT 16.1 RT to forward March 1st to whole group RT 5